Dr. Fakhri on Daratumumab Plus VMP in Multiple Myeloma

Bita Fakhri, MD, MPH, a professor of medicine in the Division of Hematology/Oncology at the University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, discusses the data behind the frontline approval of daratumumab (Darzalex) in combination with bortezomib (Velcade), melphalan, and prednisone (VMP) in multiple myeloma.

In May 2018, the FDA approved daratumumab plus VMP for the treatment of patients with newly diagnosed disease who are ineligible for stem cell transplant. The decision was based on phase III findings from the ALCYONE study. The study had outstanding results, Fakhri says, meeting all its efficacy endpoints. The progression free survival at about 16 months was significantly better in the daratumumab with VMP group compared with VMP alone. The objective response rate was also much higher, notes Fakhri.

VMP is a primarily European regimen that is not often utilized by American physicians, states Fakhri. However, the approval dispels the notion that elderly and frail patients cannot tolerate combination therapy. Not only did these patients benefit in the trial, but they were able to tolerate it very well. The toxicity profiles were similar compared with the younger population, adds Fakhri.